A (Office Use Only) Encroachment Permit Permit #: City of Seaside Public Works 440 Harcourt Avenue Seaside, Ca 93955 Phone: (831) 899-6825, Fax: (831) 899-6211 All information except signature must be typed or legibly printed. Notify City 48 hours in advance before start of project. (831) 899-6825 Date Issued: Applicant/Permittee: Expiration Permit Fee: Receipt #: Bond Fee: Receipt #: Phone# Mailing Address: Applicant/Permittee is Contractor:No Contractor: Yes Phone# Mailing Address: Applicant/ Permittee State Contractor's License # Seaside Business License # Certificate of Liability Insurance on file with the City of Seaside: No Yes Applicant/Permittee hereby agrees to comply with the Standard Conditions attached as Exhibit A, and special provisions outlined in this permit and all City Ordinances, Resolutions, Standards and Specifications currently in force. Execution below shall confirm that contractor and/or Applicant/Permittee has received and reviewed the Standard Conditions, understands the same and agrees to be bound thereby. B Applicant/Permittee Signature: Contractor Signature: Job Address/Location: Project Location & Description APN: Type of Encroachment: Check all that apply: Excavation Size (Sq. Ft.) Project Description: Cross Street: Street Improvement: Street Excavation: Sidewalk: Other: Driveway Approach: S:\Engineering\Forms 1 Revised 3/19
C Applicant/Permittee to notify the following: Underground Service Alert (800)-227-2600 Seaside Police Department (831)-899-6748 Seaside Fire Department (831)-899-6790 Monterey-Salinas Tansit, fax work location (831)-899-7789 AMR Ambulance Service (831)-718-9555 Permit Conditions (Office Use Only) Latitude/Longitude: Traffic Control/Lane Drop Required: Sidewalk Closure Required: Yes: Yes: No: No: Special Provisions: Permit # D Seaside Public Works/Engineering Department Permit Issued By Signature: Issuance & Acceptance (Office Use Only) I have examined the work covered by this permit and find that it is in accordance with the standards of the City of Seaside. Encroachment Inspector Signature: O.K. To Release Bond: Yes: Comments: No: S:\Engineering\Forms 2 Revised 3/19
EXHIBIT A CITY OF SEASIDE PERMIT TO ENCROACH I. STANDARD CONDITIONS A. Permittee or Permittee's authorized representative must notify the City of Seaside (the City) at least 48 hours before starting any work under this Permit. Failure to so notify is cause for revocation of Permit. Should Permittee fail to commence the work or project for which this permit was issued within 180 days from the date of issuance set forth above or fail to actively and diligently exercise the privileges of this Permit, the Permit becomes null and void. B. The City shall not be responsible for monitoring the Permittee s compliance with any laws or regulations. If the Permittee performs any work knowing or having reason to know that it is contrary to laws or regulations, the Permittee shall bear all claims, costs, losses, and damages (including but not limited to all fees and charges of engineers, architects, attorneys, and other professionals and all court or arbitration or other dispute resolution costs) arising out of or relating to such work. C. Permittee or Permittee's authorized representative shall notify (underground service alert) at least 24 hours before commencing any excavation necessary to perform the work authorized by this Permit. Permittee agrees to contact and obtain an Inquiry ID Number from (underground service alert) 800-227-2600 at least two (2) working days prior to commencing work. By signing this Permit application, Permittee acknowledges that Permittee understands the statutes and regulations pertaining to excavation near or in the vicinity of underground utilities and agrees to strictly conform all of Permittee s activities to such requirements. And failure on the part of Permittee to comply with such requirements shall be grounds for the immediate revocation of this Permit. D. A copy of this Permit shall be kept at the site of the work throughout the period of operations within the jurisdictional limits of the City and any right-of-way therein and shall be shown to any City employee, agent or duly authorized representative or any law enforcement officer upon demand. E. This Permit is valid only for the purpose specified herein. No change to the scope of work as identified in the application and/or drawings submitted therewith is permitted except upon written permission of the City Engineer or his/her duly authorized representative. F. Compliance with the American with Disabilities Act (ADA): All work shall be conducted in compliance with all applicable Federal, State, and Local Access Laws, regulations and guidelines including but not limited to the Americans with Disabilities Act Accessibility Guidelines (ADAAG), the Public Rights-of- Way Guidelines (PROWG), Design Information Bulletin 82-05, Pedestrian Accessibility Guidelines for Highway Projects and the City s encroachment permit and encroachment permit packet shall be approved by the City s California Licensed Professional Engineer, Licensed Architect, or Licensed Landscape Architect, Activities and uses authorized under this Permit are subject to any instruction of the City Engineer or his/her designated representative, including but not limited to the Public Works Inspector. All instructions must be strictly observed. G. The permittee shall, upon notice from the Public Works Director repair any injury, damage or nuisance in any portion of the right-of-way caused to City infrastructure by reason of exercise of this Permit. Damage shall be replaced or repaired by Permittee at his/her/its sole expense to the satisfaction of the City. Upon notice of damage to City infrastructure arising from the exercise of this Permit, should Permittee fail to act within a reasonable time or should the exigencies of the injury or damage require repairs or replacement before the permittee can be notified or can respond to the notification, the City may at it's option make necessary repairs, replacement or perform the necessary work and the Permittee shall be charged with all the expenses incurred in the performance of the work. Each seperate day on which a violation of this section shall exist shall be a seperate misdemeanor and shall be punishable as set forth in SMC1.16. (Ord. 304, 1966; prior code  10-406) H. Unless otherwise specifically provided, all costs incurred by Permittee as a result of the conditions of the Permit or the exercise by City of any right, authority, or reservation contained therein shall be the sole responsibility of and shall be borne entirely by the Permittee. S:\Engineering\Forms 3 Revised 3/19
I. J. K. L. M. N. Issuance of this Permit shall not be construed as an obligation on the part of the City to assume responsibility for any damages incurred to the Permittee s improvements and/or for any injury or death to person(s) or damage to property arising out of the permitted work. This permit is non-transferable. Applicant required to pay application fee's prior to issuance of permit, unless work is for Emergency Utility Work. Unless otherwise specified herein, this Permit may be revoked or canceled at any time by the City Engineer or his/her duly authorized representative at the sole discretion of the City Engineer or his/her duly authorized representative. Upon written notice of cancellation or revocation of this Permit for any cause whatsoever, Permittee shall promptly restore City right-of-way and structures to their condition prior to the issuance of the Permit and then shall vacate City property. Should Permittee fail to promptly restore the premises or structures to a condition satisfactory to the City Engineer or his/her duly authorized representative, the City may make any and all repairs or have repairs made and Permittee will be billed and shall reimburse City for all costs incurred. Progress of work shall proceed as expeditiously as possible. If the work consists of multiple phases, each phase of work must be approved the City before proceeding with the next phase. The City Engineer or his/her designated representative may cancel the permit if the work authorized herein is not commenced within sixty (60) days of issuance and thereafter, in the opinion of the City Engineer, is not diligently prosecuted to completion. Cancellation may be effected by giving written notice thereof by sending the same to the Permittee by ordinary mail to the address shown on the application. The permittee or permittee's authorized representative shall notify the City Engineer when all work is completed. II. INSURANCE A. B. C. D. E. F. G. Permittee shall maintain and provide commercial general liability insurance, with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $2,000,000 per occurrence, $4,000,000 general aggregate, for bodily injury, personal injury, and property damage. The policy must include coverage for contractual liability that has not been amended. Any endorsement restricting standard ISO insured contract language will not be accepted. Any insurance proceeds available to Permittee in excess of the minimum limits and coverage set forth in this Permit and which is applicable to a given loss or claim shall be deemed by this Permit to be applicable to the City. A certificate of insurance evidencing this coverage shall be provided to the City prior to the start of any work under this Encroachment Permit. The City s Risk Manager may from time to time increase the limits of the required insurance coverage. The City is to be named as an additional insured with an endorsement in favor of the City. Coverage provided by Permittee shall be primary and any insurance or self-insurance procured or maintained by City shall not be required to contribute with it. The limits of insurance required herein may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain, or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect it as a named insured. A severability of interests provision must apply for all additional insureds ensuring that Permittee s insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the insurer s limits of liability. The policy(ies) shall not contain any cross-liability exclusions. None of the coverages required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved in writing. If Permittee maintains higher limits than the minimums shown above, City requires and shall be entitled to coverage for the higher limits maintained by Permittee. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Permittee must also maintain worker s compensation insurance as required by State law. S:\Engineering\Forms 4 Revised 3/19
III. INDEMNITY AGREEMENT A. Permittee shall indemnify, defend, and hold harmless City, its officers, employees, and agents from any and all losses, costs, expenses, claims, liabilities, actions, or damages, including liability for injuries to any person or persons or damage to property arising at any time during and/or arising out of or in any way connected with Permittee s authorized activities under the terms of this permit unless solely caused by the gross negligence or willful misconduct of City, its officers, employees, or agents. B. It is expressly understood and agreed between the parties to this Permit that this is an agreement and permit for access to and for certain events to occur or work to take place on City property. This Agreement and permit is not a construction contract or an agreement for design professional services as those terms are defined or used under Title 12 of the California Civil Code ( 2772 et. seq.). IV. DUTY TO DEFEND A. As an express and material term of City s issuance of this Permit, Permittee agrees to defend, at its sole expense, the Indemnitees from and against any and all Claims arising out of or related to the permitted encroachment. Permittee s duty to defend shall apply immediately upon demand from the Indemnitees for any injury or death to persons or damage to property occasioned by reason of or arising out of the acts or omissions of the City, its officers, employees and/or agents and the acts or omissions of Permittee, his/her/its agents, employees, contractors and subcontractors and/or any other person or entity performing work authorized by this Permit. B. In the event of any controversy, claim or dispute arising out of or relating to this Permit or the violation of any covenant contained herein, the prevailing party shall be entitled to receive from the losing party reasonable expenses, including attorney s fees and costs. C. The City Engineer or his/her designated representative may, either at the time of the issuance of this permit or at any time thereafter until the completion of the work, prescribe such additional conditions as he/she may deem necessary for the protection of the public property or for the prevention of undue interference with traffic or to assure public safety. V. OTHER CONDITIONS A. Care of Drainage If the proposed work alters surface runoff or interferes with established drainage, ample provisions shall be made by the Permittee to provide adequate drainage and erosion control as approved by the City Engineer. Construction waste or excavated materials will not be allowed to be washed into the storm drain or sewer system. B. Maintenance The Permittee agrees by acceptance of this permit to exercise reasonable care to properly maintain utilities within the City right of way and to inspect for and immediately repair any damage to any improvement within the right of way which occurs as a result of the Permittee activities. C. Test Results If necessary, the Permittee shall provide the City Engineer with soil compaction test results. Compliance with compaction requirements shall be certified by a City-approved materials testing laboratory with local experience. D. Pavement Replacement Permittee shall backfill excavtion in accordance with the City of Seaside Standards. Slurry backfill shall remain a minimum of 4 inches below the finished surface. Permitte shall place 4 inches of Cold Mix Asphalt as a temporary pavement surface. At the discretion of the City Engineer the Permittee shall install 4 inches of Hot Mix Asphalt suraface in accordance with City standards. E. Protection of Traffic Provide protection for the traveling public. Barricades shall be placed with flashing amber lights at night. Flag persons shall be provided if necessary. Warning signs, lights and temporary traffic control devices shall be placed in conformance with the requirements of the City Engineer or Inspector and the Caltrans Manual of Traffic Control. S:\Engineering\Forms 5 Revised 3/19
F. Storage of Materials No material shall be stored within two (2) feet of the edge of the pavement, sidewalk or traveled way or within the shoulder line where the shoulders are wider than five (5) feet. No supplies or equipment shall be stored on the City Street or right-of-way. G. Cleanup Immediately, upon completion of work and after each work day, all material and debris shall be entirely removed. The right of way shall be left in the same or better condition as before work started. H. Conformance of Construction All construction shall conform to the most current Caltrans and City of Seaside standards and specifications. I. Bond Prior to permit issuance, the Permittee is required to provide a bond in the form of a Letter of Credit, Cashier s Check, Money Order, Cash, or Surety Bond in an amount determined by the City Engineer. The bond will be in the name of the City of Seaside and be held by or deposited to the City. The bond will be released or refunded to the individual submitting it upon satisfactory completion of the improvements, acceptance of the project by the City, and written request by the Permittee [SMC 12.04.020]. VI. DOCUMENTS INCORPORATED BY REFERENCE A. The following documents are incorporated into this encroachment permit. a. City Standard Plans b. Caltrans Standard Plans c. Caltrans Standard Specifications B. In the event of conflict in the referenced documents for this encroachment permit, the order of precedence from highest to lowest shall be as follows; i. ii. iii. iv. v. vi. vii. viii ix. Permits and Licenses Project Specific Conditions found in Exhibit B to the Encroachment Permit Standard Conditions found in Exhibit A to the encroachment Permit Project Plans Revised Standard Specifications Standard Specifications Revised Standard Plans Standard Plans Supplemental project information S:\Engineering\Forms 6 Revised 3/19